Zosteriform cutaneous leishmaniasis diagnosed with the help of dermoscopy

Abstract

Cutaneous leishmaniasis is usually easy to recognize; however, several atypical features exist, which may pose a diagnostic challenge. Here we report a 55-year-old female patient, who presented with an itchy and painful eruption localized in a dermatomal distribution along the right upper chest. Although the clinical appearance of the lesions suggested the diagnosis of herpes zoster, dermoscopic evaluation revealed erythema, hyperkeratosis, burst star whitish appearance and hairpin vessels, compatible with the diagnosis of cutaneous leishmaniasis. Indeed, leishmania amastigotes were detected by smear from the lesions. Zosteriform presentation of cutaneous leishmaniasis, as exemplified by our patient, is especially rare. In our case dermoscopy has proven to be an accessible and easy tool to diagnose such atypical presentation of cutaneous leishmaniasis, and dermatologists in endemic areas should be familiar with its typical dermoscopic features.

Chronic zoster-form

“…Clinically, the manifestations of cutaneous leishmaniasis vary from a single nodule or papule, which heals within a few months, to chronic forms that remain for several years [7]. Many of these lesions are typical and present no diagnostic difficulties [8,9]. However, a zosterform variant is rare, and the reasons for such an unusual clinical variant are not clear, and to our knowledge have only been reported as an unusual clinical variant of cutaneous leishmaniasis [4,10].…”

Zosteriform Cutaneous Leishmaniasis of the Elbow

“…The overall frequency of atypical presentations of CL is estimated at 2.5% [3,4]. The zosteriform one is exceptional [1,3,5], and only anecdotally reported in the literature [5].…”

Prevalence of co-existing dermatological manifestations in cutaneous leishmaniasis

“…9 Rare presentationsof eczematisation were reported in many studies. 10,11 Rare presentation of nonhealing ulcer over a lip in an Italian man who left the country 19-year back was diagnosed as Leishmaniasis. 2 HIV-Leishmania co-infection has caused unusual presentations and different treatment responses in India.…”